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Montana rates for HCPCS B4083

Stomach Tube - Levine Type (Special Coverage Instructions Apply. See Cim: 65-10 And Mcm: 2130 4450)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $6.59 / $6.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.85 / $2.85 / $2.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.85 / $2.85 / $2.85
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.85 / $2.85 / $2.85
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.86 / $1.86 / $2.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.68 / $3.04 / $4.15